Newswise — Physicians treating patients who complain of unexplained fatigue and tiredness with medications for depression and high blood pressure may be missing the underlying cause of their patients problems, according to a major new study by researchers at Intermountain Health Care's LDS Hospitals Sleep Disorders Center.

LDS Hospital researchers analyzed the records of more than 200,000 patients and found that those prescribed medications for both depression and hypertension were up to 18 times more likely to eventually be diagnosed with obstructive sleep apnea, a serious sleep disorder characterized by loud snoring and pauses in breathing during sleep that affects an estimated 10 percent of Americans.

"What this tells us is that patients are routinely treated for the symptoms and complications of obstructive sleep apnea while the underlying pathophysiologic condition proceeds unabated," says Robert J. Farney, MD, medical director of the LDS Hospital Sleep Disorders Center and principal investigator of the study.

The study is published this week in the April issue of CHEST, the cardiopulmonary and critical care journal of the American College of Chest Physicians.

"We have been impressed by the regular stream of patients whose risk factors are conspicuous and who ultimately present for evaluation for obstructive sleep apnea after years of having been treated for secondary manifestations of this problem," says Dr. Farney.

He says hypertension and chronic fatigue, which are possibly the most common conditions for which patients seek medical attention, are the cardinal elements of obstructive sleep apnea.

"Depression or chronic fatigue syndrome is readily diagnosed in patients with the primary complaint of fatigue," says Dr. Farney. Accordingly, these patients are frequently treated with antidepressant medications although unrecognized sleep apnea might be present.

Its estimated that the diagnosis of sleep apnea is missed in 82 percent of men and 93 percent of women with moderate-to-severe obstructive sleep apnea.

The study is significant, say researchers, because if therapy with these medications represents a marker for obstructive sleep apnea, then practicing clinicians should be alerted by this association to the possibility that sleep apnea may be the underlying cause.

If an accurate diagnosis is made, the disorder can be treated with relatively simple methods. The most common treatment method is nasal CPAP therapy (continuous positive airway pressure). This allows patients to breath air pressure through a mask while asleep. Treatment can lead to a significant improvement of quality and life for sleep apnea patients and reduce risks of associated complications.

Previous research by the LDS Hospital Sleep Disorders Center has shown a significant link between obstructive sleep apnea and left ventricular hypertrophy, a life-threatening heart problem that may affect up to 25 million Americans.

Other members of the LDS Hospital research team include Alejandro Lugo, B.A.; Robert L. Jensen, Ph.D.; James M. Walker, Ph.D.; and Tom Cloward, MD.

MEDIA CONTACT
Register for reporter access to contact details
CITATIONS

Chest, April Issue (Apr-2004)